NR 283 Final Exam
Student Name
Chamberlain University
NR-283: Pathophysiology
Prof. Name
Date
Comprehensive Study Guide: Gastrointestinal & Urinary System Disorders
Chapter 17 – Gastrointestinal System
What is a Hiatal Hernia and what causes it?
A hiatal hernia occurs when part of the stomach protrudes upward through the diaphragm into the thoracic cavity. There are two main types: sliding hernia and paraesophageal hernia.
Causes:
- Weakening of the diaphragm muscle
- Shortening of the esophagus
- Increased abdominal pressure (obesity, pregnancy, heavy lifting, chronic coughing)
- Trauma to the abdomen
Signs/Symptoms:
- Heartburn (pyrosis), sour taste in mouth
- Belching and dysphagia
- Discomfort aggravated by lying flat, bending, or coughing
- Mild chest pain radiating to jaw or shoulder
Complication: Strangulation of the herniated portion, requiring urgent surgery.
| Cause | Signs/Symptoms | Complications |
|---|---|---|
| Weak diaphragm, short esophagus, ↑ abdominal pressure | Heartburn, belching, dysphagia, chest pain | Strangulation |
What is Acute Gastritis and what factors contribute to it?
Acute gastritis is sudden inflammation of the stomach lining.
Causes:
- Infection (bacterial or viral)
- Allergies to food or drugs
- Alcohol, spicy foods, NSAIDs, aspirin
- Toxic substances or corrosives
- Radiation or chemotherapy
Symptoms: Anorexia, nausea, vomiting, epigastric pain, fever, headache, diarrhea, hematemesis.
What is Chronic Gastritis and who is at risk?
Chronic gastritis involves thinning of the stomach mucosa with loss of secretory glands.
Risk factors:
- H. pylori infection
- Long-term NSAID use
- Autoimmune disorders
- Smoking and alcohol
- Chronic peptic ulcers
- Advanced age
Symptoms: Vague epigastric discomfort, poor appetite, intolerance to spicy/fatty meals.
What is Peptic Ulcer Disease (PUD) and how does it present?
Peptic ulcers are open sores in the stomach, duodenum, or lower esophagus.
Causes: H. pylori, NSAIDs, excessive acid, impaired mucosal defenses.
Symptoms:
- Burning epigastric pain (timing differs for gastric vs. duodenal)
- Heartburn, nausea, vomiting
- Weight changes
- Anemia or occult blood in stool
| Ulcer Type | Pain Timing | Common Cause |
|---|---|---|
| Duodenal | Pain when stomach empty | Excess acid |
| Gastric | Pain after meals | Weak mucosal defenses |
What is Cholelithiasis (Gallstones) and who is at risk?
Gallstones form from bile components in the gallbladder.
Risk factors: Female sex, age >40, obesity, high cholesterol diet, multiple pregnancies, Native American descent, estrogen therapy.
Symptoms: Often asymptomatic; biliary colic, RUQ pain radiating to shoulder/back, nausea, vomiting, jaundice.
NR 283 Final Exam
What are the different types of Hepatitis?
| Type | Transmission | Course |
|---|---|---|
| HAV | Fecal-oral | Self-limiting |
| HBV | Blood, body fluids | May become chronic |
| HCV | Blood | Often chronic, risk of cirrhosis/cancer |
What is Hepatic Encephalopathy?
Neurological impairment from buildup of toxins (especially ammonia) in advanced liver disease. Causes confusion, tremors, altered consciousness, coma.
What is Cirrhosis and what complications may occur?
Chronic irreversible scarring of the liver from alcohol, hepatitis, bile duct disorders, or metabolic disease.
Complications: Portal hypertension, ascites, varices, encephalopathy, liver failure.
What are Esophageal Varices?
Dilated veins in the lower esophagus from portal hypertension; prone to rupture and massive bleeding.
What is Crohn’s Disease and how does it differ from Ulcerative Colitis?
| Feature | Crohn’s Disease | Ulcerative Colitis |
|---|---|---|
| Location | Any GI tract segment | Colon & rectum |
| Pattern | Patchy, transmural | Continuous, mucosal |
| Stool | Non-bloody diarrhea | Bloody diarrhea |
What is Appendicitis?
Acute appendix inflammation from obstruction and infection. Causes RLQ pain, rebound tenderness, fever, nausea; risk of rupture and peritonitis.
What is an Intestinal Obstruction?
Blockage of intestinal contents due to mechanical or functional causes. Leads to cramping, vomiting, distension, dehydration.
What is Gastric Cancer and who is at risk?
Cancer of stomach mucosal glands, often in the antrum. Risks: H. pylori, smoked/preserved foods, chronic gastritis, family history.
What is Pancreatitis and how does it present?
Inflammation from autodigestion of the pancreas (often due to gallstones, alcohol, fatty meals). Severe epigastric pain radiating to back, nausea, vomiting, shock risk.
What is Gastroesophageal Reflux Disease (GERD)?
Chronic acid reflux from a weak LES. Causes heartburn, regurgitation, cough; may lead to strictures or Barrett’s esophagus.
Chapter 18 – Urinary System Disorders
What is the difference between Upper and Lower Urinary Tract Infections?
| Type of UTI | Location | Symptoms |
|---|---|---|
| Cystitis | Bladder | Dysuria, urgency, frequency, cloudy urine |
| Pyelonephritis | Kidneys | Flank pain, fever, chills, nausea, urinary symptoms |
What causes Glomerulonephritis and how does it present?
Often follows streptococcal infection or autoimmune disease. Symptoms: hematuria, proteinuria, edema, hypertension, oliguria.
What is Nephrotic Syndrome?
Massive proteinuria, hypoalbuminemia, severe edema, hyperlipidemia. Caused by glomerular damage (diabetes, lupus, minimal change disease).
What is Urolithiasis (Kidney Stones) and who is at risk?
Solid mineral deposits in urinary tract from dehydration, high calcium/oxalate diet, gout, UTIs, family history.
| Stone Type | Composition | Risk Factors |
|---|---|---|
| Calcium | Calcium salts | High calcium, hyperparathyroidism |
| Struvite | Magnesium ammonium phosphate | Chronic UTIs |
| Uric acid | Uric acid | Gout, high purine diet |
What is Hydronephrosis and what causes it?
Dilation of renal pelvis/calyces from obstruction (stones, tumors, strictures, prostate enlargement). Can cause kidney damage.
What is Polycystic Kidney Disease (PKD)?
Genetic disorder with multiple kidney cysts. Leads to enlarged kidneys, hypertension, hematuria, kidney failure.
What is Acute Kidney Injury (AKI) and what are its stages?
Sudden kidney function decline.
Stages: Oliguric → Diuretic → Recovery.
What is Chronic Kidney Disease (CKD) and what are its complications?
Gradual irreversible kidney damage. Complications: uremia, anemia, bone disease, cardiovascular issues.
What is Bladder Cancer?
Malignancy of bladder lining, linked to smoking, chemical exposure. Painless hematuria is common.
What is Wilms Tumor (Nephroblastoma)?
Childhood kidney cancer; large abdominal mass, hematuria, hypertension.
What are the common diagnostic tests for Urinary Disorders?
Urinalysis, urine culture, blood tests (BUN, creatinine), imaging (ultrasound, CT, MRI), cystoscopy.
References
Porth, C. M. (2015). Essentials of pathophysiology: Concepts of altered health states (4th ed.). Wolters Kluwer.
Huether, S. E., & McCance, K. L. (2019). Understanding pathophysiology (7th ed.). Elsevier.
NR 283 Final Exam
McCance, K. L., & Huether, S. E. (2022). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.